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    Late Starting New Pack of Birth Control
    An_245696 posted:
    I just got my new pack of birth control pills a 6 days late. I was supposed to start a new pack on Sunday and just got my new pack today, Saturday. Do I start the new pack now? I have been on Loestrin 24 for 7 years.[br>
    Jane Harrison Hohner, RN, RNP responded:
    Dear An: The reason fro starting a new pack no later than seven days off active hormones is the fear that the ovaries will "wake up" and begin to active the hormonal sequence responsible for ovulation.

    Having said that, in one study of 99 women (Elomaa, 1998) the women were asked to deliberately start their new pill pack three days late. This would create a ten day vacation off the hormones. Ultrasounds of the ovaries and blood hormone levels were taken. While many women showed enlarged follicles in the ovaries, no one actually ovulated. Thus suppression of ovulation may actually extend beyond the recommended seven days of sugar pills. However, as lower doses of synthetic estrogen are used (e.g. 20 micrograms in your Loestrin 24), it becomes more likely that a dominant follicle might actually ovulate (van Huesden, 1999).

    You do have an option to start your new pack today (Sunday 6/2/2012). It is called the Quick Start regimen. Here is a citation of this from the National Library of Medicine site:

    Obstet Gynecol. 2007 Jun;109(6):1270-6. Links
    Comment in:
    Obstet Gynecol. 2007 Jun;109(6):1266-7.
    Initiation of oral contraceptives using a quick start compared with a conventional start: a randomized controlled trial.
    Westhoff C, Heartwell S, Edwards S, Zieman M, Cushman L, Robilotto C, Stuart G, Morroni C, Kalmuss D.
    Department of Obstetrics and Gynecology, Columbia University, New York, New York, USA.
    OBJECTIVE: To estimate whether young women taking the first pill on the day of prescription had higher continuation rates and lower pregnancy rates than women who waited until menses to start the oral contraceptive pill (OCP). METHODS: We recruited 1,716 women aged younger than 25 years seeking to initiate the oral contraceptive at three publicly funded family planning clinics, and randomly assigned them to conventional initiation of the pill (conventional start) or immediate, directly observed ingestion of the first pill (quick start) during the clinic visit. Women underwent follow-up interviews at 3 and 6 months. RESULTS: Sixty percent of participants discontinued the pill, and 8% became pregnant during follow-up. Women who took the first pill in the clinic were more likely to continue to the second OCP pack (odds ratio 1.5, 95% confidence interval 1.0-2.1.); however, the Quick Start approach did not improve OCP continuation rates at 3 and 6 months. Those assigned to Quick Start were slightly less likely to become pregnant within 6 months from the time they started the pill (hazard ratio 0.90, 95% confidence interval 0.64-1.25). Eighty-one percent of women rated the Quick Start approach as acceptable or preferable to waiting. Rates of serious adverse events were low and similar in the two groups. CONCLUSION: Protocols that require a woman to wait until the next menses to start hormonal contraceptives are an obstacle to contraceptive initiation. Directly observed, immediate initiation of the pill improves short-term continuation.

    An_245696, to do "Quick Start" one first has to be assured that they are not pregnant. The birth control pills (BCPs) can be started at anytime but must be followed by a seven day usage of a reliable back up method. If there has been any unprotected sex since being off the Loestrin active pills one needs to do a pregnancy test two weeks after starting the "Quick Start" regimen.

    As always it is best to consult with the GYN or clinic who wrote your prescription.

    aubreyd106 replied to Jane Harrison Hohner, RN, RNP's response:
    Jane, I have a quick question for you. So my next birth control pack should be started on May 26. However, I would like to wait a week AFTER that. Because on June 13- June 21 I will be seeing my boyfriend and I don't want to have my period during that time. So if I am going to be having sex between the 13 and 21, will I be safe since my pack technically won't end till the 22? Or will starting my next pack a week late mess everything up? Thank you for your time.

    georgiagail replied to aubreyd106's response:
    Why don't you simply skip the week of placebo pills in your new pack to avoid triggering the bleeding that women assume is menstruation and simply go onto the next pack of pills?

    aubreyd106 replied to georgiagail's response:
    Thank you Gail, I wasn't sure if it was safe to do that.

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